Not Worth a Shot: Why Some Christians Refuse Vaccinations on Moral Grounds

Given the speed with which an epidemic can rage through a community, Paul, the differences between Typhoid Mary and modern anti-vaxxers are not as big as they ought to be. Mary was imprisoned/quarantined, yes, and rightly so, because she was getting people killed and large scale vaccination was not practical—the vaccine was used only by the military in her time. Even today, the typhoid fever vaccine is effective for only a couple of years, so the reason you don’t have reason to fear it is because, quite frankly, quarantines work.

Measles is somewhat different since the vaccination can last for two decades. However, if the situation gets quite a bit worse—say tens of thousands of infections and a number of deaths in New York City—public health officials are going to need to give those communities a choice; get vaccinated, or get quarantined.

Describe the risks accurately, yes—but let’s remember that the reason we don’t have huge fear of things like smallpox and polio is because generations before us made some hard choices to accept these risks to protect their neighbors.

[Bert Perry]

Describe the risks accurately, yes—but let’s remember that the reason we don’t have huge fear of things like smallpox and polio is because generations before us made some hard choices to accept these risks to protect their neighbors.

I’m not convinced that people were that altruistic in their motivation. What previous generations had was *experience* with polio and smallpox, and they knew how bad they were and thus were willing to take some risk with the vaccine to prevent worse consequences down the road (consequences they hadn’t just heard about, but likely had seen in others or maybe experienced themselves). While generations before us were certainly more self-sacrificing than ours, I rather doubt parents would have made a risky choice to risk their own child getting a disease or having some potentially debilitating side-effect to supposedly help protect their neighbors, though a few might have.

And back then, there were justified reasons to fear vaccines — sometimes QC was not so great, and vaccines got out that caused the disease they were trying to prevent. But again, the likelihood of bad consequences for not vaccinating was much higher than parents have today with larger amounts of herd immunity. With that reduced risk, the need for being open and honest about the actual risks (i.e. very small but NOT non-existent) will help convince parents to make the right choice. The “trust us” line is just not going to work, especially in this day and age where trust and respect of authority is much reduced from that of previous generations (and while not a welcome development, it’s not always completely without justification). What parents hear when they hear “trust us” about something like vaccination is “The needs of the many outweigh the needs of the few, or of the one.” Not very comforting.

Actually, this article about the unveiling of the Salk vaccine does indicate that people could and did do a little bit of relative risk analysis. 300,000 people, confronted with the risks of polio, knowingly took the risks of the early Salk vaccine. When the relative risk came out about the same as the placebo, millions more joined them, and the results were announced on nationwide TV/radio.

No doubt that “trust us” just won’t work, but it’s not like we can’t look back a few decades and see what happens when we don’t take care of these things. As I noted above, people above age 65 or so are genuinely perplexed about why people don’t work with this, because they remember the days when their friends were going into the iron lung. Their parents remember the names of relatives lost in the 1918 flu epidemic.

We can either heed history, or we can re-learn it.

[Bert Perry]

No doubt that “trust us” just won’t work, but it’s not like we can’t look back a few decades and see what happens when we don’t take care of these things. As I noted above, people above age 65 or so are genuinely perplexed about why people don’t work with this, because they remember the days when their friends were going into the iron lung. Their parents remember the names of relatives lost in the 1918 flu epidemic.

We can either heed history, or we can re-learn it.

I mostly agree. It was an easy call for me on diseases like Polio. But when some people hear things like “Polio has been 99.9% eradicated,” then they re-evaluate the risk/reward for vaccination, since they believe their chances of catching it are much less than was the case a couple generations back, even if non-zero. They probably figure that others will take the risks, so they don’t need to. The people above 65 have too much experience, so they probably would never consider not vaccinating. Plus, as you noted, their generation already took the risks.

People should indeed learn from history, but since that often doesn’t happen (cf. socialism), then why not explain more to them? Having more information about the actual numbers would help more than it would hinder, but it seems the authorities think the opposite — it’s almost like they think if any information gets out it means even less people will vaccinate. Unfortunately, social engineers always seem to come to the conclusion that an ignorant populace is better, since they can be controlled and dissenters can just be silenced. They just don’t seem to get that human nature doesn’t work that way.

I don’t actually know what information doctors give out now when preparing parents for vaccinations, but in the early 90’s when I was having children of that age, they were definitely trying to convince me that there were no risks I need worry about. I ended up vaccinating, but in spite of what they said rather than because of it. I’m not at all surprised that other parents are resistant to that sort of advice being passed off as “expertise.”

My kids started in 1998, and we had about the same experience—that the materials encouraging vaccination left “a little to be desired” in the persuasion department. The most infuriating thing, though, is that the consequences of not vaccinating are pretty darned straightforward. Vaccination does not confer intergenerational immunity, so if you’ve got the pathogen out there, not vaccinating over time will lead to similar disasters as we had in the past.

You can “scale” it by estimating herd immunity and the incremental impact of people choosing not to vaccinate, and you can determine “communities at risk” by plotting out vaccination rates by neighborhood or town, but the long and short of it is that the consequences of not taking MMR are very significant outbreaks in measles, mumps, and rubella in and around the affected communities. It’s infuriating that the case is not made because it’s so straightforward.

[Bert Perry]

The most infuriating thing, though, is that the consequences of not vaccinating are pretty darned straightforward. Vaccination does not confer intergenerational immunity, so if you’ve got the pathogen out there, not vaccinating over time will lead to similar disasters as we had in the past.

That’s just it though. While I agree with what you are saying, the consequences of not vaccinating are definitely *less* than they were in the past. I don’t mean for someone who gets the disease, or what will happen when it spreads, but I’m speaking about the chances of getting it in the first place. Some of these anti-vaxxer parents are seeing that many kids who aren’t vaccinated don’t get those diseases, probably both because they are not as prevalent in the wild, and because most everyone else is vaccinated. Because of that, and because they don’t get good answers on the risks, they make the wrong choice and choose not to vaccinate, thinking that the risk of not vaccinating is less. I would agree with you that it’s a wrong conclusion, at least for most diseases that have vaccinations available, but that shows exactly why the medical community should do much better than “trust us.”

It’s infuriating that the case is not made because it’s so straightforward.

I could not agree with this more.

Yes, we don’t have the obvious reservoirs of various plagues out there like we did in the past, but we have to remember that these things (again, a^n) grow exponentially and can sneak up on us in a hurry. At that point, our main defense, if a “critical mass” does not vaccinate, against things getting as bad as they used to be is the fact that most of us don’t live in tenements anymore. Single family homes without a person for every 50-100 square feet amount to a partial quarantine.

Which is a long way of saying that the difference between then and now is that we’ve got a few extra weeks to prepare, and slightly slower transmission. Maybe. Knowing that, I’m actually somewhat uneasy that our fix for smallpox (if some sadist releases it again from some vial in or outside of Atlanta) is just a few vials at the CDC.